It was reported about a week ago that David Festa will miss the remainder of the season due to a setback with his shoulder injury. It was disappointing, but with the Twins not making the playoffs this year, at least it appeared that Festa would likely be ready for the 2026 season. However, the latest update on Festa's injury suggests that the young pitcher may not return at all next season. And when he does eventually return, Festa may unfortunately see a decline in performance.
Twins believe starting pitcher David Festa suffering from thoracic outlet syndrome
Festa, 25, met with Dr. Keith Meister in Texas this week. After the visit, Twins head trainer Nick Paparesta told Betsy Helfand of the St. Paul Pioneer Press that he believes Festa is suffering from neurological thoracic outlet syndrome. Festa will meet with another doctor before the Twins develop a treatment plan.
Paparesta likely meant to use the word "neurogenic" rather than "neurological," as the two types of thoracic outlet syndromes (TOS) are "venous" and "neurogenic," according to Jesse Dougherty of The Washington Post.
While venous TOS tends to have less long-term impact, multiple pitchers who suffered from neurogenic TOS have notably declined in performance since being diagnosed. Stephen Strasburg made just eight starts after undergoing neurogenic TOS surgery, and Chris Archer and Matt Harvey went from elite starters to struggling veterans after undergoing neurogenic TOS surgery.
When Festa, who posted a 5.40 ERA with a 23.1% strikeout rate and 8.3% walk rate in 53 1/3 innings with the Twins this season, eventually returns, it will likely be in a bullpen role. Barring any trades, the Twins' 2026 rotation will consist of Joe Ryan, Pablo López, Bailey Ober and Zebby Matthews, with Taj Bradley, Mick Abel, Simeon Woods Richardson and Kendry Rojas expected to get starting opportunities as well. Even if Festa, who had a 2.59 ERA with a 32.0% strikeout rate and 5.7% walk rate in 33 1/3 innings for Triple-A St. Paul this season, was healthy, many signs still point toward him converting into a reliever, as he typically fails to pitch deep into games but still has a solid pitch arsenal.